We will present the case of a 52 year old patient, admitted to our Department for exertional angina, with 2 recent acute events – inferior myocardial infarction and stroke. The coronary angiography revealed patent coronary arteries, without atherosclerotic lesions. The transthoracic echocardiography established the presence of an interatrial septal aneurysm with interatrial shunt. Under these circumstances, we have considered the presence of paradoxical embolism as a potential pathophysiological mechanism of the acute ischemic events. The percutaneous closure of the interatrial shunt to prevent the recurrence of embolic events will be discussed.